Free American Board of Internal Medicine exam questions

ABIM Review

The American Board of Internal Medicine (ABIM) offers certification in the subspecialty of Gastroenterology. There are a number of requirements before certification can be earned, including being previously certified in Internal Medicine by ABIM, demonstrating clinical competence, and owning a valid and unrestricted license to practice medicine. The certificate earned by those who pass the examination is valid for 10 years.

The examination lasts one full day. A variety of editions (also called “forms”) are used on the exam and there may be a slight difference between them in question order and content. The exam consists of what is called “single best answer questions only.” The questions contain a brief statement as well as a case history, graph, or picture followed by a question and a list of possible options. Although only one answer may be chosen, some answer options may be partially correct but not determined to be the correct answer. Questions asked may include those pertaining to making a diagnosis, determining a treatment or management plan, ordering diagnostic tests, recognizing clinical features of a disease, or determining means of prevention, screening, staging, or follow-up.

There are seven different content categories covered on the exam: esophagus, stomach/duodenum, liver, biliary tract, pancreas, small intestine, and colon. With the exception of the liver section, which consists of 25 percent of the exam, each of the other sections counts for between 10 percent and 18 percent of the total exam. In addition, there are a variety of subcategories covered in each section.

Test takers either pass or fail the examination. Answers should be provided for all questions, as unanswered questions are scored as incorrect. The minimum passing score to receive certification reflects an absolute standard that has been established by the exam committee. A Score Report will be mailed following the examination but not for up to three months. Test takers will also receive an email notification that their results have been released, but not until they have also been mailed. Copies of the report results will be maintained for two years following their release. Questions regarding the exam can only be submitted in writing to the ABIM and must be received within six months from when scores are released. From 2008 to 2012, the first-time pass rate for those taking the gastroenterology exam ranged from 89 percent in 2010 to 97 percent in 2009.

The gastroenterology exam is offered only twice every calendar year. Registration opens approximately six to eight months before the exam and closes approximately four to six months before the exam. The deadline for late registration is generally a month after the deadline for the initial registration period. The deadline to cancel taking the exam is approximately one to two months before the exam. The cost to take the exam depends on whether test takers currently only hold certification in Internal Medicine or if they also have a subspecialty certification (in which case they will be charged slightly more). The fee is valid for 10 years and includes one secure examination and access to an unlimited number of self-evaluation products provided by ABIM. Those who need to re-take the exam are charged a fee less than the original enrollment fee.

Test takers are strongly encouraged to view the ABIM website in advance of taking the exam, which offers tutorials to view as well as practice exams and answer keys.

The exam is long and generally takes approximately 10 hours to complete. Test takers are given three optional breaks, and the four different sessions take up to two hours each, during which test takers will be asked a maximum of 60 questions (the total number of questions asked may differ slightly depending on which exam version is being taken). On exam day, test takers should also prepare to take a tutorial (though this is optional), a pledge of honesty, and another optional survey at the end of the exam. Test takers are allowed to take virtually anything into the testing area with them, including all electronic devices, study materials, writing instruments, notes, wallets and purses, and food and drinks. Lunch can and should be brought to the testing center, but cannot be brought into the actual testing area.

American Board of Internal Medicine exam questions and answers

Here are 59 free American Board of Internal Medicine exam questions and answers on the Gastroenterology to help you prepare for the American board exam. All questions are in mutiple choice format as the real certification exam. Take it, see instant answers, learn and you will get qualified the ABIM licensing examination.

Free American Board of Internal Medicine exam questions

Take our Internal Medicine exam questions and answers in two sections to learn and prepare your official ABIM exam. It contains 59 questions is divided in to two sections.

ABIM practice exam with 59 free Internal Medicine exam questions and answers is not timed and free, so you may take it as many times as you wish.

Free Gastroenterology practice questions and answers

frequently related to gastroesophageal reflux; empiric therapy with acid suppression is the recommended first therapeutic intervention. Typically presents with noncardiac chest pain. The diagnosis is made manometrically by the finding of more than 20% of swallows having simultaneous contractions in the distal esophagus. Barium esophagography shows a segmented or "corkscrew" esophagus. Can try a calcium channel blocker if PPI fails.

Diffuse esophageal spasm

gastroesophageal reflux disease

dyspepsia

hematochezia

An ulcer with a visible vessel as a cause of upper gastrointestinal bleeding has an approximately 50% risk of rebleeding if not treated endoscopically.

obscure gastrointestinal bleeding.

Caustic ingestion

gastrointestinal bleeding

Megaloblastic anemia

Patients whose Crohn disease becomes refractory to immunomodulator therapy should be given anti-tumor necrosis factor-α inhibitor therapy. Early use of infliximab has been shown to be more effective than conventional management with corticosteroids for induction of remission.

celiac disease

ulcerative colitis

Refractory Crohns disease

Pericolic abscess

For persons with a family history of colorectal cancer in a first-degree relative or an adenomatous polyp, screening is initiated either at age 40 years or beginning 10 years earlier than the diagnosis of the youngest affected family member whichever comes first. The recommended surveillance modality and interval is colonoscopy every 3 to 5 years. Fecal occult blood testing is a recommended screening modality in the average-risk population but not in patients at increased risk. With no family history colonoscopy every 10 years or annual fecal occult blood testing that requires that two samples be collected from each of three spontaneously passed stools or Flexible sigmoidoscopy in combination with fecal occult blood testing in 5-year intervals would be an option as well.

colorectal cancer screening

pancreatic cancer

Chronic mesenteric ischemia

chronic pancreatitis

Patients with inflammatory bowel disease should initiate screening for colorectal cancer after 8 years of duration of disease.follow-up colonoscopy every 1 to 2 years.

colon cancer follow up surveillance

Manage gallstone pancreatitis

Manage new-onset ascites

Manage colon cancer risk in a patient with inflammatory bowel disease

Antibiotics, endoscopic variceal band ligation, and intravenous octreotide are the first-line therapies for acute esophageal variceal bleeding.octreotide reduces portal venous blood inflow through inhibition of the release of vasodilatory hormones. Surgical consultation should also be considered in patients who rebleed, in patients who require a large number of transfusions, and for large ulcers of the lesser curve of the stomach or posterior wall of the duodenum. An ulcer with a visible vessel has an approximately 50% risk of rebleeding if not treated endoscopically.

Manage upper gastrointestinal bleeding

gastrointestinal bleeding

acute gastrointestinal bleeding

Treat ulcerative colitis

Patients with primary sclerosing cholangitis are at risk for developing cholangiocarcinoma (lifetime prevalence of 10% to 30%). painless jaundice, very elevated CA 19-9 and weight loss.Intrahepatic biliary dilation and mass at the biliary bifurcation are seen.

cholangiocarcinoma

colonic polyps

Hyperbilirubinemia

gastric adenocarcinoma

A circumscribed pouch found in the proximal third of the esophagus.Clinical manifestations such as dysphagia (difficulty swallowing), and sense of a lump in the neck; moreover, it may fill up with food, causing regurgitation (reappearance of ingested food in the mouth), cough (as some food may be regurgitated into the airways), halitosis (smelly breath, as stagnant food is digested by microorganisms), potential infection of the pharyngeal areas due to food stuck, and involuntary gurgling noises when swallowing.

Zenker's diverticulum

peptic ulcer disease

fulminant liver failure

diverticulitis

High-grade dysplasia detected at a surveillance colonoscopy for ulcerative colitis necessitates total proctocolectomy. cancer risk persists throughout the colon, particularly in patient who has had severe pancolitis in the past.

Microscopic colitis

ulcerative colitis

hepatitis C virus

Treat ulcerative colitis

Cholestyramine is a treatment for bile salt-induced diarrhea. ileocecal valve and terminal ileum are the most important locations for bile salt reabsorption.When larger amounts of bile acids enter the large intestine, they stimulate water secretion and intestinal motility in the colon, which causes symptoms of chronic diarrhea.Cholestyramine will act as a binder and help prevent these bile salts from directly stimulating the colon.

celiac disease

bile salt-induced diarrhea

hepatitis C virus

Mesenteric ischemia

Also called traveler's diarrhea, an infection of the small intestine caused by Giardia lamblia, a flagellate protozoon that produces cysts. The source of infection is usually untreated contaminated water.The mainstay of diagnosis of giardiasis is microscopic examination of the stool. This can be for motile trophozoites or for the distinctive oval G.lamblia cysts.Metronidazole is first line treatment.

pain increases with eating, weight loss, known risk factors for atherosclerosis, and prescence of abdominal bruits

acute mesenteric ischemia

cholangiocarcinoma

pancreatic necrosis

Chronic mesenteric ischemia

Endoscopic polypectomy is the treatment of choice for most gastric adenomatous polyps.

pancreatic necrosis

gastrointenstinal bleeding

gastric adenomatous polyp

Barrett esophagus

Topical therapy with corticosteroids or mesalamine is appropriate for distal ulcerative colitis. Oral prednisone is used when symptoms do not respond to 5-aminosalicylates.Azathioprine or 6-mercaptopurine (6-MP) may be used for patients who have incomplete disease remission while on corticosteroids.These agents are nucleotide analogues that interfere with DNA synthesis and induce apoptosis. Therapy with these agents may be required for up to 3 months before providing clinical benefit, and therefore, they are generally started with corticosteroids, which are then tapered.

diverticulitis

ulcerative colitis

Ischemic colitis

Crohn colitis

Proton pump inhibitors are the drugs of choice in NSAID-induced gastric injury whether or not NSAID therapy is discontinued. The inhibition of prostaglandin synthesis, which results in decreased surface mucus, bicarbonate secretion, and epithelial proliferation, all of which make the mucosa more susceptible to injury.

cholestatic liver profile, serum alkaline phosphatase levels three to five times (with sclerosis less alk phos versus PBC) greater than normal and mild hyperbilirubinemia. Magnetic resonance cholangiopancreatography is used to make diagnosis.

Primary sclerosing cholangitis

Ischemic colitis

primary biliary cirrhosis

Microscopic colitis

the most common and most benign pregnancy-related liver disorder, often presents in the second or third trimester of pregnancy and is associated with pruritus and mild elevation of the bilirubin level with or without a mild elevation of the aminotransferase levels. Treatment consists of symptomatic relief to the mother, with ursodeoxycholic acid being the first drug of choice.

cholangiocarcinoma

Barrett esophagus

bariatric surgery

Cholestasis of pregnancy

Diabetic autonomic dysmotility may manifest as constipation or diarrhea and is usually seen in the setting of other end-organ disease; treatment is generally supportive.

Hepatic adenomas

Chronic radiation proctitis

severe alcoholic hepatitis

diarrhea in diabetic autonomic dysmotility

marker for celiac disease.

Antiendomysial antibodies

Aphthous stomatitis

intestinal amoebiasis

Octreotide

failure of ductal systems to fuse; drainage through duct of Santorini; can cause acute pancreatitis.No specific treatment is necessary.

Pancreas divisum

achalasia

gastroparesis

Hepatitis B

Variceal hemorrhage occurs in 25% to 40% of patients with cirrhosis; upper endoscopy is indicated in patients with newly diagnosed cirrhosis.

newly diagnosed cirrhosis

celiac disease

hereditary hemochromatosis

primary biliary cirrhosis

NSAID-induced injury to the bowel is a relatively common cause of small-bowel ulceration and may present with obscure gastrointestinal bleeding.

average risk for colon cancer

Manage a bleeding ulcer of the small bowel

bile salt-induced diarrhea

Manage hepatic abscess

Screening for colorectal cancer in the average-risk population should be started at age 50 years.

pancreatic cancer

gastric adenocarcinoma

average risk for colon cancer

Graft vs host disease

There are two forms of bariatric surgery: restrictive procedures limit caloric intake by reducing the stomach"s capacity; malabsorptive procedures decrease the effectiveness of nutrient absorption by shortening the functional small intestine. Pulmonary embolism is an infrequent early complication after bariatric surgery, but it accounts for 50% of deaths in these patients. Iron deficiency occurs in nearly 50% of patients after Roux-en-Y gastric bypass as a result of alteration in gastric acid that affects iron reduction and from bypassing the proximal small bowel where iron absorption is maximal.

The best imaging modality to confirm suspected diverticulitis and evaluate for extraluminal complications (such as perforation, abscess, obstruction, and fistula) is a contrast-enhanced CT scan. left lower quadrant pain, fever, and elevated leukocyte count are classic symptoms and signs.

ulcerative colitis

diverticulitis

Crohn colitis

diverticular bleed

Prophylactic colectomy is indicated if more than a hundred polyps are present, if there are severely dysplastic polyps, or if multiple polyps larger than 1 cm are present.

ulcerative colitis

Treat ulcerative colitis

Familial adenomatous polyposis

Chronic radiation proctitis

All HBV carriers who are to undergo immunosuppression should be treated prophylactically with antiviral therapy until 6 months after immunosuppression completed.Lamivudine is first choice.